An Adult Epilepsy Monitoring Unit (EMU) at Cleveland Clinic Akron General opened last year. Shown here are team members Camille Goldberg, RN, and Gregory Bilowsky, RN, CNRN.
Epilepsy can be a “hidden” health problem. First, it is difficult and often slow to diagnose since many other neurologic disorders, which produce similar bellwether changes in behavior, can be confused with epilepsy. And, since seizures — a key manifestation — rarely happen in a doctor’s office, information given to the physician by the patient and their family about events is extremely important. Yet, even with accurate descriptions of symptoms and signs, other tests, some requiring an in-patient hospital stay, are needed to learn more about the seizure types, what is causing the events, and where the problem is located. Lastly, many individuals suffering from epilepsy have their lives limited by the effects of the disorder, making the health problem even less visible to the outside world.
However, epilepsy is a growing disorder that affects many. The Epilepsy Foundation estimates that more than 2.2 million Americans are currently living with the disorder, and 150,000 new cases of epilepsy are diagnosed in the US every year. According to a 2010 study by the Institute of Medicine, epilepsy is the 4th most common neurological problem. Only migraine, stroke, and Alzheimer’s disease occur more frequently.
Fortunately, physicians in Akron and the surrounding areas now have access to state-of-the-art epilepsy care for their patients through the new Adult Epilepsy Monitoring Unit (EMU) at Cleveland Clinic Akron General.
“Patients who traveled to Cleveland for epilepsy monitoring can now receive the same great care closer to home in our new Epilepsy Monitoring Unit,” says Brian Harte, MD, President of Cleveland Clinic Akron General. “The EMU is an important addition to our medical center and continues our progress in enhancing care for the Akron community.”
The Akron General facility features the most advanced all-digital video EEG (electroencephalography) equipment available. Operating around the clock, the unit is staffed by a team of nurses, EEG technologists specializing in epilepsy, and world-renowned epileptologists (board-certified neurologists with subspecialty training in epilepsy) from the Cleveland Clinic Epilepsy Center.
Imad Najm, MD, is Director of Cleveland Clinic’s Epilepsy Center, one of the largest and most comprehensive programs in the world for the evaluation, medical and surgical treatment of epilepsy. The team also includes specialists in neurology, neurosurgery, neuroradiology, nuclear medicine, psychology and psychiatry, as well as a large group of specialized nurses, social workers and clinical technologists.
“The expansion of our epilepsy services to Akron General and the surrounding communities is a great benefit for area physicians, who may have previously needed to send patients to the Cleveland area for treatment,” says Dr. Najm. “Reducing travel and transportation while providing access to the same world-class care once only available in Cleveland, also allows for heightened satisfaction, an improved experience and better seizure management for patients and their loved ones.”
Akron General’s EMU has 4 private rooms, which helps provide the ideal setting for Dr. Najm and his team to monitor patients, so they can understand and diagnose their seizures accurately and design the best treatment plan.
Kelly Langenbeck, CNP, works with a patient at Cleveland Clinic Akron General’s outpatient epilepsy clinic.
The new EMU is connected to Cleveland Clinic’s Central Monitoring Unit, one of the first in the world to serve as a live control center with EEG and video monitoring capability 24 hours a day, 365 days a year. If a patient suffers a seizure, it is immediately detected in the Central Monitoring Unit and reported live to the nursing staff and clinical providers for timely management of the patient.
“Some people don’t remember having a seizure if it happens when they are alone, and many times these patients don’t believe they’ve had any seizures for months” says Dr. Najm. “Monitoring and recording of events in our unit allows us to help these individuals understand that they may be having many more seizures than they ever realized.”
To thoroughly locate the source of seizures, Dr. Najm says the brain’s activity must be studied carefully. To do this, patients in the EMU are monitored throughout the day and night, both by EEG equipment to monitor brain wave activity and video cameras to record body movements during a seizure. The length of time patients spend in the unit varies but usually ranges from three to five days.
Imad Najm, MD, Director, Cleveland Clinic Epilepsy Center
“Patients’ brain waves are monitored around the clock, and we are able to see what their brain does during the seizure,” says Dr. Najm. “Understanding what kind of seizure is occurring allows us to then begin the process of putting the patient on the right treatment.”
After monitoring is complete, Dr. Najm and other members of his EMU team discuss the findings with the patient and explain what treatment option is best. In addition, some cases are presented and discussed at the Cleveland Clinic Epilepsy Center’s multidisciplinary Patient Management Conference. Recommendations for additional testing or surgical resection are then discussed with the patient.
Adding support to the services of Akron General’s EMU is a new outpatient epilepsy clinic, providing convenient access to Cleveland Clinic’s Epilepsy Center.
“Epilepsy is difficult to treat, and unless we diagnose it accurately, we can’t manage it appropriately,” says Dr. Najm. “The comprehensive resources, technology, and highly skilled team of specialized physicians and support staff of our new EMU now allow for a higher level of care for this disorder, and we look forward to helping more patients with the service.”
For more information about Cleveland Clinic Akron General Adult Epilepsy Monitoring Unit and outpatient epilepsy clinic, call 330-344-8990 or visit clevelandclinic.org/epilepsycenter.